Postpartum stress incontinence – causes, symptoms and treatments

If you thought that you could breathe easy after childbirth, with the thought that most of your physiological and even psychological woes are now behind you, you've got another think coming. Postpartum issues can vary greatly in severity and not all women will experience all of the issues, but at times sever postpartum problems can make the previous nine months look like a walk in the park. One of the most common postpartum troubles that women face after childbirth is stress incontinence or urinary incontinence.

What leads to stress incontinence after childbirth?

During labour the pelvic floor muscles, along with the ligaments, nerves and muscles of the lower abdomen go into an overdrive, working together to help the delivery and expel the baby out of the womb. Remember these are the same muscles that also help in keeping the urethra closed so that urine doesn't leak out involuntarily. But excessive wear and tear during delivery can lead to injury or trauma to this set of muscles and ligaments that subsequently might fail to do their job as they did pre-labour. This could lead to involuntary leaking of urine causing stress or urinary incontinence post delivery.

Do all women suffer from stress incontinence postpartum?

Like pregnancy, postpartum issues too don't affect all mothers in the same way. While some women might have to deal with the problem others might remain blissfully ignorant to the existence of such issues after childbirth. Stress incontinence is more common among women who have birthed naturally or have undergone some degree of trauma during labour. In some cases however, assisted natural deliveries, such as those including the use of vacuum pumps or forceps can also lead to the same.

That said, women who have a planned C-section or an emergency one are not always spared this annoyance. They too might suffer from some degree of incontinence after the delivery, though it is most common with women who have gone through natural labour.

What are the likely causes that lead to stress incontinence?

It is believed that the condition most commonly develops in women who undergo natural labour. Here are some additional causes that can contribute to the problem:

• Long labour hours, especially the third stage when one needs to push hard to expel the baby out. This makes the muscles of the pelvic floor work beyond their capacity and tends to weaken them in the process.
• Sometimes the labour process can shift the position of the urethra and the bladder a little, which can lead to weakening of the surrounding muscles and loss of control over bladder functions.
• Episiotomy, a cut made in the pelvic area to allow the baby to slide out with ease leaves a surgical wound. This takes time to heal and for the muscles to gain back their strength and function properly. Until that time incontinence may be an unavoidable problem that has to be dealt with.
• Birthing babies who have a slightly larger head can also lead to enough trauma and pressure during the delivery. The obvious result is loosening of the pelvic floor muscles.
• Multiple vaginal deliveries are also thought to be a probable cause for the same.
• Obese women are also prone to facing incontinence post delivery if birthed naturally.
• Smoking also increase the probability manifolds.
• Additionally, as one ages the problem can become a lot more severe and harder to deal with.

How can stress incontinence be treated post delivery?

Usually, the incontinence settles on its own at least six weeks after the delivery, as the vaginal muscles heal and regain their strength to control urine flow. If this doesn't happen though, there are ways to deal with it:

• Always use the restroom as soon as you feel the urge, so that you don't leak profusely.
• Use maternity pads to help keep your undergarments from getting damp or wet, as that can again give rise to infections in the vaginal area.
• Practise Kegels exercises to strengthen the muscles of your pelvic floor to counter incontinence.
• If incontinence interferes with your regular activities talk to your doctor for a solution. In extreme cases, surgery is suggested to counter the problem. Keep in mind that although surgery can give you relief from the condition, it also has its own set of shortcomings, so get a thorough diagnosis done before you opt for one.

When should one worry about it?

Some degree of incontinence is natural in women as they age, but if you notice that your problem is affecting your life to such an extent that you are unable to exercise any control over your bladder function and urinate even without feeling an urge for the same, it should be warning enough that your condition needs urgent attention. Though this isn't a life threatening condition, it can be extremely uncomfortable to deal with, causing a great deal of discomfort and awkwardness.

Image source: Getty images

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• How to plan for a birth without violence
• How to write a good birth plan
• A new mums guide to bond better with the baby
• Tips to deal with swollen feet or edema during pregnancy
• 10 important facts about induced labour

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